ASSESSING THE EFFECTIVENESS OF A REVISED BRAIN TUMOUR PATHWAY: A CLINICAL AUDIT OF PATIENT CARE AND HEALTHCARE PROCESSES

Abstract AIMS The majority of patients with a newly diagnosed brain tumour present through the A&E department. This pre- sentation pathway is often poorly co-ordinated and is run by resident doctors in differing hospital departments leading to extended hospital stays and unnecessary scans. A new brain tumour pathway was implemented in 2023 across a number of trusts within Merseyside to try and standardise the care of this patient group. This study aims to evaluate the impact of the new pathway on patient care. METHODS A retrospective analysis of 93 patients from 3 Merseyside acute hospital trust (Whiston, Warrington, and South- port) who had introduced the pathway were examined between January and December both before (2022) and after (2024) pathway introduction. Data was obtained from the Orion referral platform and the hospital elec- tronic records (eP2). Mann-Whitney U test and Chi-squared tests were used to assess significance. RESULTS During this period, 51 patients in 2022 and 42 patients in 2024 were referred of which 33 had a primary brain tumour and 60 had metastasis. Pathway implementation led to a reduction in the length of hospital stay follow- ing a diagnostic scan in 2024 in comparison to 2022 (p=0.00051) and a 27.8% improvement in SDEC (Same Day Emergency Care) discharges within 24 hours (20.8% in 2022; 48.6% in 2024; p=0.00683). There was no change in the number of MRI head with contrast before referral and CT CAP, despite there being clear guidelines in the pathway. Finally, the number of times the referring hospital contacted Walton over Orion after the referral increased in 2024 compared to 2022 (mean = 1.1, 0.5, respectively; p=0.00384). CONCLUSION Following introduction of the pathway, there were more same day discharges from A&E, but few people followed the scanning recommendations. Further work to understand the differential success and failure of different parts of the pathway is ongoing.